Transcript: George S. Hecker, 1969-70

Please note: The Becker Medical Library presents this oral history interview as part of the record of the past. This primary historical resource may reflect the attitudes, perspectives, and beliefs of different times and of the interviewee. The Becker Medical Library does not endorse the views expressed in this interview, which may contain materials offensive to some users.

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Interview #1 — December 16, 1969

This is archives collection oral history interview #6 recorded on December 16, 1969 with Mr. George S. Hecker concerning his experiences on the Barnard Free Skin and Cancer Hospital Board of Trustees from 1951 to the present. Mr. Hecker has been a member of the Board of Directors of the Barnard Free Skin and Cancer Hospital in St. Louis from 1951 to the present, Secretary of the Board between 1955 and 1960, President of the Board from 1961 to the present, and Treasurer of the Washington University Medical School and Affiliated Hospitals from 1964 to the present.

I think before I start talking, I should place Barnard Hospital in its historical context, because much of what has occurred in Barnard since its affiliation with Washington University Medical School is a result of transition from its original concept to the present unit within the framework of the legal instruments which constitute the bases of the hospital’s existence. These instruments are deeds of gift from George D. Barnard of certain land, to a hospital formed in the early 1900s for the purpose of the care and treatment of medically indigent cancer patients. These gifts of land were gifts on condition. They required that the land be used for the purposes of the hospital, that the hospital be a free hospital, and I believe it was in the deeds of gift that he required that the Hospital be named the Barnard Free Skin and Cancer Hospital.

The deeds of gift of the land also provided that the restrictions were to follow with the land. That is to say, if the land given by the deeds of gift were sold, the proceeds would have to be reinvested in land and improvements for the purpose of continuing on the hospital. These early deeds of gift – it’s my best recollection – were for land in what is now Forest Park. You’d have to refer to the deeds of gift if they are available to get the precise locations of these parcels of land.

Barnard was a well-to-do philanthropist who had no children. A group of doctors, including Dr. [Frederick J.] Taussig, at the turn of the century, were concerned with the fact that poor [patients] ridden with cancer were unable to obtain hospital beds for care and treatment, both because of the limited number of beds available and also because of the expense. These doctors banded together and volunteered their time and talents for the care and treatment of the medically indigent cancer poor and they interested Barnard in contributing money to this cause. This became perhaps Barnard’s chief philanthropic interest and hence the deeds of gift. When he died, he made a provision for his wife and provision for the hospital. He created trusts which are still in existence and of which the hospital is the primary beneficiary. His wife elected to take against his will, and realizing what she had done after the fact several years later, she again became one of the principal supporters of the hospital which bore her husband’s name. In her will [she] created a trust which was in substitution for the consequences of what she did when she elected to take against [his] will, and so we have a trust under the will of Mary L. Barnard which also underpins the finances of the hospital.

The hospital moved from Forest Park to Washington just east of Grand and constructed a building in which it operated for many, many years as a specialty hospital – which achieved worldwide recognition and fame for cancer research, which was performed by such individuals as [Dr. Edmund V.] Cowdry, and others. It was a free hospital. That is to say that all patients who were admitted to the hospital were medically indigent and no charges were ever made for any care received in Barnard. The physicians volunteered their time and talents free, also. This was a very unique hospital. But during the latter part of the forties, hospital expenses increased [and] the building became older and older. The hospital was in need of new equipment; it was an independent hospital, not affiliated with the university medical school.

It became increasingly apparent that the hospital was on a one-way road to economic extinction unless moves were made to affiliate it with a hospital. The history of the struggle to affiliate with Washington University Hospital was written in the law books in the latter part of the forties. The hospital’s officers, under the leadership of John Shepley, the then-president of the hospital, commenced negotiations with the medical school for affiliation with the medical school. It was contemplated that the hospital, Barnard, would sell its land and facilities, and purchase a tract of land within the medical center immediately north of the present Barnes Hospital, between Barnes and what is now Wohl Hospital. Parenthetically, Mr. [David] Wohl was a member of the Barnard board and he was proposing at that point in time to contribute monies with which to build Wohl Hospital. It was the plan that Wohl Hospital would be a “pay” cancer hospital; Barnard would be attached to Wohl and would be a medically indigent “free” cancer hospital. The medical school would furnish the staff. We [Barnard Hospital] would affiliate with Barnes and utilize its heat, light, power, laundry, food, services – nursing services and so on. Any deficit which might arise from the free care rendered patients in Barnard would be picked up by the profit, if you will, derived from pay patients in Wohl and other hospitals in the [medical] center. It was on that basis that Barnard moved into the medical center and constructed its five-story facility and commenced operations.

Within the first six months of operation, Barnard had incurred a deficit of some $40,000 and called upon the Barnes trustees to pick up the deficit from the other hospital operations in the center. The Barnes trustees said that they could not pick up the deficit because that would be using funds of one charity for the charitable purposes of another, namely Barnard. This was in contradiction to what had been understood to be the arrangement between the Barnard board and the medical school and what the Barnes trustees thought they understood the arrangement to be. And, parenthetically, what was the arrangement that was approved by the Supreme Court of Missouri when it refused to issue a quo rado and oust the Barnard Corporation Board and revoke the hospital’s charter when its move to the medical center here was challenged by the Attorney General of Missouri at the behest of some who were concerned that it was affiliating with Washington University, and not with St. Louis University, and would thereby lose its public entity.

In any event, in 1954 or 1955, when we commenced operations and incurred the deficit, we then renegotiated an agreement with the Barnes trustees by which we would, over a period of years, pay off the deficit which we incurred so rapidly in the first six months of operation. Then we were required to shut down one of the bed floors for lack of operating funds. That is to say, we did not have the money to provide free care on one whole floor. We were then concerned with the future of the hospital. Unless we could fully utilize its facilities we would have to go out of existence.

We filed a suit in the Circuit Court of St. Louis asking for a construction of the wills and deeds of gift of Mr. and Mrs. Barnard. Specifically, we wanted to know whether or not, if we applied all of our monies available toward free care, we could then utilize the bed facilities of Barnard for pay patients in order to keep the hospital fully used. A decree was entered in 1958 or 1959 which construed the wills and deeds of gift of the Barnards to permit the hospital to charge patients provided that it utilize all of its monies derived from the Barnard trusts and in balance for free care. We were then able to meet the problem of rising costs of the hospital care. As costs have risen, the number of free beds available in the hospital has been proportionately reduced and we have been able to take into the hospital cancer patients who could pay only a part of their care.

At the same time as this lawsuit [was proceeding] we discussed our problems with Dean [Edward W.] Dempsey of the medical school. At that point of time, the National Institutes of Health was initiating a program of clinical research centers across the country. Ed Dempsey suggested that the hospital and the medical school apply to the National Institutes of Health for a grant which would permit the installation of a clinical research center in Barnard that would be utilized by the entire medical center. Such an application was made, the grant was awarded, and Washington University, as the research agent of Barnard Hospital, then commenced the operations of the clinical research center in Barnard, which I understand has achieved national, if not international, recognition for the work performed within the clinical research center. We utilized the one floor that we had shut down for lack of funds for the clinical research beds. The clinical research operation became so successful that it required additional space.

At that point of time, we had approximately $90,000 in restricted research funds as well as about $125,000 in funds derived from the Women’s Advertising Club Gridiron Dinner, an annual affair, which had been given to Barnard for cancer research. These funds were lying idle, not generating sufficient income to warrant the expenditure of income for minimal research. We discussed this again with authorities within the medical school, and they suggested that research funds, or rather funds for the conduct of research, were readily available. The greatest need in the medical center was room in which such research could be performed. The board was then confronted with a major policy decision that would literally transform the hospital from one emphasis upon free care to the medically indigent cancer patient to one of free care, of the same type of free care, for cancer patients in connection with clinical research and peer research. We decided to enter into a long-term program to convert the hospital from one of simple bed treatment of free cancer patients to a highly-integrated research unit, using as a base the free care of cancer patients. That program was completed last year, in 1968.

We added three more floors to the hospital without having to go to the public for funds. We utilized some of our endowment funds, our research funds, and government grants. The medical school contributed, I believe it was $75,000 or $100,000 toward the construction without conditions, that is to say, without strings. At this juncture the Barnard Hospital is now this highly-integrated research unit. In the basement we have a cyclotron. On the second floor we have laboratory facilities. On the third floor free cancer patient care. On the fourth floor a clinical research bed unit. On the fifth floor a clinical research bed unit. On the sixth floor the Women’s Advertising Club Research Laboratory, which was built with funds derived primarily from the annual Gridiron Dinner of the Women’s Advertising Club in St. Louis, and in which is conducted the radioisotope research and a good deal of cancer research. The seventh floor will be converted – the south half for dermatology, the north half for laboratories. And on the eighth floor a most elaborate animal quarters.

The hospital, during its twenty-year or so affiliation with Washington University, has gone through a major transformation. It remains a free hospital with emphasis upon free care for the medically indigent, but at the same time it is achieving once again national and international recognition for the research which is being performed within its halls by Washington University Medical School physicians who are agents of the Barnard Free Skin and Cancer Hospital. At the same time that we were going through this transformation as a hospital, Barnard participated in the formation of WUMSAH, the Washington University Medical School and Associated Hospitals Corporation, which will be the subject of another tape [interview].

Interview #2 — January 7, 1970

This is archives collection oral history interview #7 recorded on January 7, 1969 [1970] with George S. Hecker, presently a member of the Board of Directors of the Barnard Free Skin and Cancer Hospital and president of that board between 1960 and 1969. Mr. Hecker was also a member of the Washington University Medical School and Associated Hospitals, Inc. Board from its creation in 1962 through 1969, as well as secretary and treasurer of the board at various times during this period.

These are random reflections upon the sequence of events involving the organization of WUMSAH, that is, the Washington University Medical School and Associated Hospitals, Inc., the medical center organization, and certain problems with which the center organization was confronted during the period immediately following its creation and through 1964.

I have today delivered to the Vice Chancellor of Medicine [ed. note: the correct title is Vice Chancellor for Medical Affairs] my personal files respecting the negotiations and drafts of the agreement for the creation of the medical center, the Articles of Incorporation and Bylaws of the Medical Center, various correspondence relating to the negotiations and organization of the medical center, and problems with which it was confronted, including the dispute, or difference of opinion, if you will, between the Medical School on the one hand and the Barnes’ trustees, through primarily their chairman, Edgar M. Queeny, on the other. [This dispute] culminated in the creation, in 1964, of the position of Vice Chancellor for Medical Affairs of the University, who under the bylaws of WUMSAH is the President of the medical center as well as Vice Chancellor in charge of Medical Affairs [ed. note: the correct title is Vice Chancellor for Medical Affairs] of the University.

The files which I am leaving with the Vice Chancellor – presumably they will be delivered by the Vice Chancellor’s office to the library – contain in some detail a full report of the negotiations resulting in the Articles of Incorporation and Bylaws of the Medical Center. I would refer you particularly to the copies of the minutes of the Board of Directors of the Barnard Free Skin and Cancer Hospital dated May 22, 1961, October 23, 1961, December 12, 1961, and February 20, 1962 for the more detailed report on the negotiations leading to the agreement for the creation of the medical center. I also would refer you to that slip in my files which contain the memorandum of Edward Dempsey, then Dean of the Medical School, to the liaison committee of the boards dated April 21, 1961 and entitled, “Proposal for the Creation of a Washington University Medical Center,” as well as the copies of the eight or nine drafts of the Agreement for the Creation of the Medical Center. Each of the drafts followed a negotiating session of representatives of the various institutions constituting the members of the Center and reflect the changes in the previous drafts agreed upon at each negotiation session. They therefore will show by a play-by-play account of the problems with which the institutions grappled in the organization of the center itself.

Very briefly, the loose confederation of the institutions known as the medical center had existed for a number of years without a head. It was a huge center and it was really without any central control structured into the relationships between the hospitals and the medical school. Barnes, Children’s, and Barnard [Hospitals] each had a contract with Washington University Medical School by terms of which, among other things, the faculty of the medical school constituted the staffs of the various hospitals. Also by contract, the Barnes trustees operated the Washington University Hospitals – Maternity, McMillan, Wohl, Renard, and also the Irene [Walter] Johnson Institute of Rehabilitation and Wohl Clinics. Also by contract, Barnes trustees were the operating agents of the Barnard Free Skin and Cancer Hospital. Children’s, of course, had an agreement with the Medical School, but operated its own hospital with its own administrative staff.

The increase in size and complexity of the problems of the various institutions constituting the center created serious problems with administrative coordination, land use and allocation, long-term planning of appropriate hospital care, and teaching in the research programs. The then-existing loose confederation simply did not lend itself to any intelligent joint cooperative planning, fundraising, or to operating the center as an integrated unit. Therefore, the Medical School was very seriously concerned with the consequences of this rather headless operation upon its future development as a leading medical institution in the country, and Ed Dempsey, then Dean, by his memorandum of April 21 proposed the creation of a Washington University Medical Center.

This proposal was referred to the liaison committee of the various institutions in the center, that is: the Medical School, the Barnes trustees, Children’s Hospital and Barnard Hospital. From that resulted a negotiating committee consisting of representatives of the various institutions. Later, this negotiating committee was expanded to include a representative from Jewish Hospital. This, to my knowledge, was the first time that Jewish Hospital had been invited to participate as a member of the medical center, notwithstanding its physical proximity to the center itself, and was a very substantial departure from its historical relationship with Children’s, Barnard, Barnes and the Medical School. It was agreed that Jewish would become, at that point of time and henceforth, an active member of the medical center. Therefore, Jewish entered into the negotiations resulting in the creation of the center.

I won’t go through the various problems with which the negotiating committee was confronted; they’re outlined in the Barnard minutes to which I earlier alluded to. Primarily, the problem was agreeing upon a structure which would not encroach upon the institutional integrity of each of the member institutions, but at the same time would effectively provide a [means] for long-term planning, fundraising, and coordination of the day-to-day operations of the center. In addition to that primary problem, there was the problem of resolving power plays, if you will, of various institutions during the course of the negotiations, which would have resulted in one or more institutions dominating the center, contrary to the interests of the other member organizations.

The negotiations resulted in a document known as the “Agreement for the Creation of the Washington University Medical School and Associated Hospitals Medical Center.” That rather worldly name was itself the result of a compromise of a power struggle. Originally, it was proposed by one of the member organizations that it be known as the Washington University Medical Center. As I recall, it was Edgar Queeny who objected to that on the grounds that the University itself was leftishly inclined and he would have no part of the University’s name alone identifying the center. Then he – Queeny – proposed that it be known as the Barnes Medical Center. Well, this was objected to, obviously, by the other hospitals. Then Barnes and Washington University Medical School’s Medical Center [was suggested], and this was objected to by the other hospitals. Finally he [Queeny] agreed that he had no objection to the medical school’s name being included in the medical center’s name. Since the medical school was the single unifying thread throughout the center, its name was agreed to as being the dominant name, and the name finally became the Washington University Medical School and Associated Hospitals, Inc.

When, in later years, Jim McDonnell, Chairman of the Board of McDonnell Aircraft Company, now McDonnell-Douglas, became Chairman of the Medical Center Board, he in his characteristic fashion, abbreviated the center name to WUMSAH and it has been affectionately or otherwise known as WUMSAH for the subsequent years to date. The agreement for the creation of the medical center was signed by all of the member organizations, following which I drafted Articles of Incorporation for the Center Corporation under the Missouri Not for Profit Corporation Act. We filed the articles of incorporation, got our certificate of incorporation, and adopted a set of bylaws. The bylaws and the articles of incorporation include substantively the terms of the agreement between the member organizations by which the center organization itself was formed. Subsequent to incorporation there have been one or two changes in the bylaws respecting the inclusion of a new member, Central Institute for the Deaf, and as I recall, respecting amounts which each member organization contributed to the medical center in order to provide for an operating budget. It may be, and of course, the official records of WUMSAH will reflect, that the bylaws were amended to provide that the Vice Chancellor of Medical Affairs of the University was to be the President of the Medical Center.

This is an interesting story in and of itself to which I’ll allude just briefly. The rather dominant personality of Edgar Queeny contributed a great deal to the medical center in its total operations. Inevitably, the position of Barnes [Hospital] under his leadership would, in my opinion and the opinion of others, have come into conflict with the interests of the medical school and other member organizations in the center. Edgar Queeny was not a man to take a subordinate position nor to lead an institution that would be subordinate to other institutions. He was essentially a competitor of the highest quality and he recognized the problems within the center and set about to correct them. This brought into direct conflict the interests of the Medical School and Barnes. This dispute is probably chronicled elsewhere and I’ll not detail it excepting to say that it came to an acute head some time in 1964, at which time both the institutions, that is, the University and the Barnes trustees, agreed to bring in Drs. [John H.] Knowles and [Joseph C.] Hinsey and others as a committee of four to examine the problem of the underlying dispute and to make recommendations. They did so, and their report is also a part of the file which I’m delivering to the vice chancellor. I presume it will be made a part of the Library records.

Among other things, that report recommended that the University create the position of Vice Chancellor in charge of Medicine, and that the Vice Chancellor in charge of Medicine become President of the Medical Center. I might say, parenthetically, that for two years, that is, during the period from April of ’62 to April of ’64 or thereabouts, the medical center operated without a president as such – because the member institutions were unable to agree upon the nature of the man who would fill such a post and indeed on his powers and duties, notwithstanding the earlier agreement respecting his position and general priorities and duties as contained in the bylaws. There were some who felt that he should be primarily an administrator. There were others who felt that he should be a physician of outstanding rank in the country that could be primarily a man concerned with the advancement of medicine, medical education, and research. Of course it was these two different functions – the hospitals on the one hand providing medical care and the University on the other concerning itself with medical education and research. Again, this conflict was apparent and in the question of the selection of a president, and the parties simply had not been able to agree.

Following the creation of the position, the University appointed Dr. Carl Moore as the first Vice Chancellor in charge of Medical Affairs. Carl Moore, in my opinion and in the opinion of others, is low-tone, non-controversial, and has a unique ability to get people to work together. All parties agreed that Carl Moore would be an outstanding first president of the center organization, and he became such following his appointment as Vice Chancellor in charge of Medical Affairs. But Carl Moore was not anxious to hold this post for a long period of time, and when Jim McDonnell became chairman of the board, Carl Moore announced that he wished to go back to straight teaching. It was largely through the efforts of Jim McDonnell that Bill [William H.] Danforth was appointed Carl Moore’s successor, and Bill, of course, has since continued as Vice Chancellor in charge of Medical Affairs.

I believe that the existence of the WUMSAH board, as an effective body, contributed a great deal to the resolution of the conflict between the University and the Medical School [and Barnes Hospital] during the early 1960s. The board itself was a facility by which Dr. Dempsey and Edgar Queeny, representing the two institutions, were required to meet together. Because the conflict between these two institutions affected very seriously the present and future of the other member institutions of the center, the representatives of the other center institutions brought a great deal of pressure collectively to bear upon the warring parties to resolve their differences in closed session. That, if nothing else, was a most substantial contribution to the medical center organization. It’s well that it did, in fact, exist at the time that the differences became acute. I think those differences have been resolved and the parties meeting in common at the medical center board level find it extremely difficult to join battle one with the other or one against others because of the open communication existing now between all the institutions and the medical center at the highest levels in their coordinated efforts and planning.

It’s been pointed out that in the course of these comments, I may have referred to Jim McDonnell as being President of the Board of WUMSAH. If I did, that was an error. WUMSAH has a president who is the Vice Chancellor for Medical Affairs of the university. The president is the day-to-day operating officer and chief executive. The chairman of the board of the medical center is selected from among the members of the medical center board. The members of the medical center board are appointed by their respective institutions. Traditionally, that presidency [ed. note: title should be “Chairman of the Board”] has been rotated between the University, Barnes, Children’s and Jewish as being the largest of the institutions in the center. Therefore, laymen, if you will, are chairman of the board or have been chairman of the board and professionals – physicians – have been president of the center.

This concludes Archives Collection Oral History interview #7.

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